Research roundup: how spas benefit mental health

Mental health has been a hot topic for some time now. Where do spas fit in? Let’s take a look at how spas benefit mental health.

People have been talking about mental health and wellbeing as a wellness trend for a few years now. And in the wake of the COVID-19 pandemic, it’s become more important than ever to recognize and promote spa treatments as a means of addressing issues associated with mental health. 

Chronic pain, stress, and mental health disorders are common, and there are cross relationships between these conditions.

Many studies suggest a considerable association between chronic pain and depression. “In addition to depression, anxiety, and substance use disorders, individuals with chronic pain are at risk of other mental health problems.”  

Stress, meanwhile, is also linked to mental health disorders, as well as to negative physiological health outcomes, including heart disease, diabetes, and infectious diseases. Research conducted at Carnegie Mellon University found that chronic psychological stress is connected to loss of ability to regulate the inflammatory response, which may promote the development and progression of disease.

It stands to reason that if one can find relief from any one condition, there’s a good chance this will positively impact related conditions.

We know that spa treatments, including massage, thermal bathing, and sauna can have significant positive impacts on stress and pain. Let’s take a look at the research related to their direct impact on mental health and wellbeing.


Massage dates back to at least 3000 BCE in India, where it is said to have been used as an Ayurvedic treatment and believed to restore the body’s natural and physical balance, allowing for natural healing. And the American Massage Therapy Association (AMTA) states that massage therapy as an occupation dates back to the 1700s, where forerunners of today’s massage therapists were called rubbers. “Rubbers were experts in treating orthopedic problems with manual rubbing and friction.” 

Also according to the AMTA, massage therapy has multiple mental health benefits. Research has found that massage therapy can reduce anxiety associated with a number of conditions, including cancer, chronic pain and psychiatric disorders. Massage therapy is also correlated with reduced anxiety before and after surgery.

More findings include: 

  • Massage therapy can reduce symptoms of depression for individuals with HIV.
  • Back massage given during chemotherapy was associated with significantly reduced anxiety and acute fatigue.
  • Military veterans reported significant reductions in anxiety, worry, depression and physical pain after massage, as well as lower levels of tension and irritability.
  • Massage for nurses during work hours is associated with reduced stress and related symptoms, including headaches, shoulder tension, insomnia, fatigue and muscle and joint pain.

A review of studies also found that massage was associated with significant decreases in levels of the stress hormone cortisol, averaging 31%, and with increases of the neurotransmitters serotonin (28%) and dopamine (31%), both of which contribute to feelings of happiness and wellbeing. The authors wrote, “These studies combined suggest the stress-alleviating effects (decreased cortisol) and the activating effects (increased serotonin and dopamine) of massage therapy on a variety of medical conditions and stressful experiences.”

Finally, study subjects who underwent Swedish massage twice a week experienced decreases in cortisol levels and increases in oxytocin levels. Researchers also found slight evidence of increased white blood cell counts.


Saunas have been around for thousands of years. The exact origin is unknown, but today these hot houses are generally associated with Northern Europe, particularly Finland, where there are an estimated 2 million saunas for a population of 5.3 million people.

According to the US News & World Report, an Alternative Medicine Review found that sauna therapy can help ease mild depression and fatigue and has been linked to improved emotional balance in those with anorexia nervosa.

Another study noted that sauna bathing has numerous health benefits including the promotion of mental well-being and relaxation, and also found that sauna bathing was strongly associated with a reduced risk of psychotic disorders. The authors wrote, “These new findings add to emerging evidence that frequent sauna therapy could reduce the risk of several acute and chronic health conditions.”

More findings: 

  • Frequent sauna bathing can reduce the risk of dementia in men. Men who went to the sauna four to seven times a week were 66% less likely to be diagnosed with dementia, and 65% less likely to be diagnosed with Alzheimer’s disease, than those taking a sauna once a week.
  • Sauna use elicits a multitude of beneficial health effects, including improved sleep and mood-boosting benefits. “Researchers treated patients with major depressive disorder with heat so that their core body temperature reached temperatures equivalent to those experienced with sauna use. Following just one treatment session, subjects experienced elevations in mood that lasted for several weeks.” 

The act of just sitting in the sauna may also contribute to mental health benefits due to its potential to be used as time for meditation and relaxation.

Thermal bathing

People have been taking the spring and sea waters for healing purposes for millennia. The practice is said to date back to at least the times of the ancient Greeks, who considered bathing a treatment against diseases. The Romans, influenced by the Greeks, built thermal baths at mineral and thermal springs where wounded soldiers – and everyone else – would go for rest and recuperation.

Taking the warm waters in a spring or spa bath may have a range of mental health benefits. These have been shown to include decreases in self-reported levels of depression and anxiety, and improved sleep.

More findings: 

  • Balneotherapy (BT) (bathing in mineral springs) is beneficial for stress and fatigue reduction in comparison with music therapy or no therapy. Study authors concluded that geothermal water baths have a potential as an efficient approach to diminish stress caused by working or living conditions. 
  • Spa bathing is associated with reduced levels of salivary stress markers, cortisol and chromogranin, an effect that was more pronounced in people with higher levels of stress.  
  • Immersion bathing was associated with better outcomes for fatigue, stress, and pain, as well as significantly better general health, and mental health scores compared with showering.
  • Hot springs bathing has a positive impact on chronic pain and musculoskeletal conditions, which will have a positive impact on mood and stress levels. 
  • Bathing in geothermal mineral water was associated with improvements in anxiety, depression, sleep quality, and stress. Review authors stated that this has implications for the use of BT as a valid complementary therapy for people with mental health conditions.
  • Hot baths may improve depression as much as physical exercise. Afternoon baths just twice a week produced a moderate but persistent lift to mood, the size of which was similar to that seen with physical exercise, which is a recommended therapy for mild or moderate depression. 

As the conversation around mental health continues, knowing how we can contribute will help us move it forward.


We’ve released a list of the spa & wellness trends we’ll be watching next year. Click here to download the Handbook: Seven wellness trends for 2022


  1. I like that you mentioned how massages could reduce the level of stress hormone cortisol. My wife has been really stressed lately and I want her to be able to relax before any complication arose. I heard there are places that offer medical spa services so I’m thinking of having her book a session for next weekend.

  2. Thank you for noting that taking a spa bath lowers salivary levels of the stress hormones cortisol and chromogranin, with the impact being more obvious in those with higher levels of stress. My sister is under a lot of stress due to her workload. She can lessen her tension, therefore I’ll treat her to a day spa.

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